Temporal discounting in choice between delayed rewards: the role of age and income

Effectiveness and feasibility of the self-administered and repeated episodic future thinking exercises in smoking cessation

Delay discounting (DD) is associated with smoking behavior and relapses. Episodic future thinking (EFT) is one of the leading interventions shown to reduce DD. The 1-month follow-up study with 60 participants that employed EFT as active intervention and episodic recent thinking (ERT) as control intervention was conducted in participants receiving smoking cessation treatment. In EFT group, there was significant decrease in DD rates from pre-intervention to post-intervention (p = 0.009), whereas no significant change was observed in ERT group (p = 0.497). DD rates in EFT group did not change significantly over 1 month (p = 0.059), while decrease was detected in ERT group (p = 0.011). Smoking cessation rates between groups were similar (p = 0.486). Adherence with completing follow-up evaluation forms and performing relevant exercises was higher in EFT group (p = 0.038, p = 0.006). Adding EFT to usual smoking cessation treatment did not increase smoking cessation rates, however feasibility of the self-administered exercises needs to be improved to clarify clinical effects.

A psychobioecological model to understand the income-food insecurity-obesity relationship

Food insecurity, defined by unpredictable access to food that may not meet a person's nutritional needs, is associated with higher BMI (kg/m2) and obesity. People with food insecurity often have less access to food, miss meals and go hungry, which can lead to psychological and metabolic changes that favor energy conservation and weight gain. We describe a conceptual model that includes psychological (food reinforcement and delay discounting) and physiological (thermic effect of food and substrate oxidation) factors to understand how resource scarcity associated with food insecurity evolves into the food insecurity-obesity paradox. We present both animal and human translational research to describe how behavioral and metabolic adaptations to resource scarcity based on behavioral ecology theory may occur for people with food insecurity. We conclude with ideas for interventions to prevent or modify the behaviors and underlying physiology that characterize the income-food insecurity-obesity relationship.

The role of chronic pain and pain anxiety in delay discounting of pain and monetary losses

Pain may alter intertemporal decisions by modifying the value of pain-related outcomes. For example, a person with chronic back pain may be faced with two choices: undergo surgery that could provide long-term relief but would involve additional short-term pain and discomfort during recovery; or continue living with the chronic pain and avoid the surgery, thus leading to overall deteriorated health. Such choices are well captured by delay discounting, which is defined as the decline in the subjective value of an outcome as the delay of its receipt increases. We investigated general pain anxiety and delay discounting of monetary losses and pain in 255 individuals with and without chronic pain. We found that people with chronic pain tend to discount the value of pain outcomes more than those without chronic pain, suggesting that chronic pain may contribute to impulsivity in decision-making related to pain. Moreover, the effect of chronic pain on delay discounting was mediated through general pain anxiety. This result, however, should be taken with caution, because the effect sizes were small, and the path model was underpowered. In conclusion, people with chronic pain might be more likely to prioritize avoiding immediate discomfort and may undervalue the potential long-term benefits of actions that could alleviate their pain in the future.

Risk Assessment of Maladaptive Behaviors in Adolescents: Nutrition, Screen Time, Prenatal Exposure, Childhood Adversities - Adolescent Brain Cognitive Development Study

PURPOSE

We aimed to identify significant contributing factors to the risk of maladaptive behaviors, such as alcohol use disorder or obesity, in children. To achieve this, we utilized the extensive adolescent brain cognitive development data set, which encompasses a wide range of environmental, social, and nutritional factors.

METHODS

We divided our sample into equal sets (test, validation; n = 3,415 each). On exploratory factor analysis, six factor domains were identified as most significant (fat/sugar intake, screen time, and prenatal alcohol exposure, parental aggressiveness, hyperactivity, family violence, parental education, and family income) and used to stratify the children into low- (n = 975), medium- (n = 967), high- (n = 977) risk groups. Regression models were used to analyze the relationship between identified risk groups, and differences in reward sensitivity, and behavioral problems at 2-year follow-up.

RESULTS

The functional magnetic resonance imaging analyses showed reduced activation in several brain regions during reward or loss anticipation in high/medium-risk (vs. low-risk) children on a monetary incentive delay task. High-risk children exhibited heightened middle frontal cortex activity when receiving large rewards. They also displayed increased impulsive and motivated reward-seeking behaviors, along with behavioral problems. These findings replicated in our validation set, and a negative correlation between middle frontal cortexthickness and impulsivity behavior was observed in high-risk children.

DISCUSSION

Our findings show altered reward function and increased impulsiveness in high-risk adolescents. This study has implications for early risk identification and the development of prevention strategies for maladaptive behaviors in children, particularly those at high risk.

Delay Discounting and the Income-Food Insecurity-Obesity Paradox in Mothers

Food insecurity, defined as unpredictable access to food that may not meet a person's nutritional needs, is paradoxically associated with higher BMI (kg/m2) and obesity. Research has shown delay discounting, a behavioral economic measure of the preference for immediate rather than delayed rewards, is related to higher BMI, and moderates the relationship between income and food insecurity. Based on this research, we used regression models to test whether delay discounting, consideration of future consequences, and perceived stress were atemporal mediators of the food insecurity-BMI relation in 313 mothers, controlling for demographic variables. A secondary aim was to replicate the finding that delay discounting moderates the relationship between low income and high food insecurity. Results showed that low income was associated with higher food insecurity, and higher food insecurity was associated with higher BMI. Delay discounting was the only variable that was indirectly related to both paths of the food-insecurity-BMI relation. Delay discounting accounted for 22.2% of the variance in the low-income-food insecurity-obesity relation, and the total model accounted for 38.0% of the variance. The relation between low income and food insecurity was moderated by delay discounting. These data suggest that delay discounting is a potential mediator of the relationship between food insecurity and high BMI, which suggests reducing discounting in the future could be a novel target to reduce food insecurity and help people with food insecurity to reduce their excess body weight. Trial Registration. This trial is registered with NCT02873715.

Effects of economic context and reward amount on delay and probability discounting

Steep delay and shallow probability discounting are associated with myriad problem behaviors; thus, it is important to understand factors that influence the degree of discounting. The present study evaluated the effects of economic context and reward amount on delay and probability discounting. Two hundred thirteen undergraduate psychology students completed four delay- or probability-discounting tasks. Participants were exposed to hypothetical narratives involving four bank amounts ($750, $12,000, $125,000, and $2,000,000). The delayed/probabilistic amount was $3,000 for the two smaller bank amounts and $500,000 for the two larger bank amounts. The discounting tasks included five delays to, or probabilities of, receipt of the larger amount. The area under the empirical discounting function was calculated for each participant. Participants discounted delayed and uncertain outcomes more when the bank amount was smaller than the outcome (i.e., the economic context was low). Participants discounted the delayed larger amounts less than delayed smaller amounts, even when the relative economic context was the same. In contrast, probability discounting did not differ across magnitudes, which suggests that economic context may attenuate the magnitude effect in probability discounting. The results further highlight the importance of considering the economic context in delay and probability discounting.

Impulsivity and Alcohol-Drinking Behavior: Evidence from Japan

Despite the attempt by the Japanese government to reduce alcohol consumption, reduction of alcohol consumption requires improvement. We explore this issue from the impulsivity perspective and investigate whether a causal relationship exists between impulsivity and drinking behavior. We used data from the Preference Parameter Study of Osaka University to capture respondents' drinking status. Our probit regression showed that procrastination, a proxy measure of impulsivity, was significantly associated with drinking behavior, while hyperbolic discounting, a direct measure of impulsivity, was insignificant. Our findings suggest that impulsive people will discount their health in the future; thus, the government should consider impulsivity in policymaking. For example, awareness programs should focus more on future healthcare costs from alcohol-related problems so that impulsive drinkers can understand how much they may need to spend in the future compared to current satisfaction with alcohol drinking.

Differential Neural Correlates in the Prefrontal Cortex during a Delay Discounting Task in Healthy Adults: An fNIRS Study

The phenomenon of future rewards being devalued as a function of delay is referred to as delay discounting (DD). It is considered a measure of impulsivity, and steep DD characterizes psychiatric problems such as addictive disorders and attention deficit/hyperactivity disorder. This preliminarily study examined prefrontal hemodynamic activity using functional near-infrared spectroscopy (fNIRS) in healthy young adults performing a DD task. Prefrontal activity during a DD task with hypothetical monetary rewards was measured in 20 participants. A discounting rate (k-value) in the DD task was determined on the basis of a hyperbolic function. To validate the k-value, a DD questionnaire and the Barratt impulsiveness scale (BIS) were administered after fNIRS. The DD task induced a significant increase in oxygenated hemoglobin (oxy-Hb) concentration bilaterally in the frontal pole and dorsolateral prefrontal cortex (PFC) compared with a control task. Significant positive correlations were detected between left PFC activity and discounting parameters. Right frontal pole activity, however, showed significantly negative correlation with motor impulsivity as a BIS subscore. These results suggest that left and right PFCs have differential contributions when performing the DD task. The present findings suggest the idea that fNIRS measurement of prefrontal hemodynamic activity can be useful for understanding the neural mechanisms underlying DD and is applicable for assessing PFC function among psychiatric patients with impulsivity-related problems.

Strengths and Weaknesses of Everyday Financial Knowledge and Judgment Skills of Adults with ADHD

Adequate financial capability is crucial in everyday life. This capability might, however, not be given to adults with ADHD. The present study aims to determine strengths and weaknesses regarding everyday financial knowledge and judgment skills in adults with ADHD. In addition, the impact of income is explored. Forty-five adults with ADHD (M_age = 36.6, SD_age = 10.2) and 47 adults without ADHD (M_age = 38.5, SD_age = 13.0) were included and were assessed with the Financial Competence Assessment Inventory. Adults with ADHD showed decreased scores regarding awareness of the arrival of bills, knowledge of own income, having a reserve fund for unexpected expenses, the ability to state long-term financial goals, own preferences for estate management, understanding of assets, legal action for debt, access to financial advice/counseling, and the ability to compare medical insurance plans as compared with adults without ADHD (all p < 0.001). However, no effect of income was found. In conclusion, adults with ADHD have difficulties with many aspects of everyday financial knowledge and skills, which might result in a plethora of personal and legal consequences. It is, therefore, of the utmost importance that professionals who support adults with ADHD proactively ask about everyday financial functioning so that assessment, financial support, and coaching can be provided.

Hyperbolic modeling and assessment of hypothetical health behaviors during a viral outbreak using crowdsourced samples

The COVID-19 pandemic provided an opportunity to investigate factors related to public response to public health measures, which could help better prepare implementation of similar measures for inevitable future pandemics. To understand individual and environmental factors that influence likelihood in engaging in personal and public health measures, three crowdsourced convenience samples from Amazon Mechanical Turk (MTurk) completed likelihood-discounting tasks of engaging in health behaviors given a variety of hypothetical viral outbreak scenarios. Experiment 1 assessed likelihood of mask wearing for a novel virus. Experiment 2 assessed vaccination likelihood based on efficacy and cost. Experiment 3 assessed likelihood of seeking health care based on number of symptoms and cost of treatment. Volume-based measures and three-dimensional modeling were used to analyze hypothetical decision making. Hypothetical public and personal health participation increased as viral fatality increased and generally followed a hyperbolic function. Public health participation was moderated by political orientation and trust in science, whereas treatment-seeking was only moderated by income. Analytic methods used in this cross-sectional study predicted population-level outcomes that occurred later in the pandemic and can be extended to various health behaviors.

Altered delay discounting in neurodegeneration: insight into the underlying mechanisms and perspectives for clinical applications

Steeper delay discounting (i.e., the extent to which future rewards are perceived as less valuable than immediate ones) has been proposed as a transdiagnostic process across different health conditions, in particular psychiatric disorders. Impulsive decision-making is a hallmark of different neurodegenerative conditions but little is known about delay discounting in the domain of neurodegenerative conditions. We reviewed studies on delay discounting in patients with Parkinson's disease (PD) and in patients with dementia (Alzheimer's disease / AD or frontotemporal dementia / FTD). We proposed that delay discounting could be an early marker of the neurodegenerative process. We developed the idea that altered delay discounting is associated with overlapping but distinct neurocognitive mechanisms across neurodegenerative diseases: dopaminergic-related disorders of reward processing in PD, memory/projection deficits due to medial temporal atrophy in AD, modified reward processing due to orbitofrontal atrophy in FTD. Neurodegeneration could provide a framework to decipher the neuropsychological mechanisms of value-based decision-making. Further, delay discounting could become a marker of interest in clinical practice, in particular for differential diagnosis.

Age-Related Changes in Risky Decision Making and Associated Neural Circuitry in a Rat Model

Altered decision making at advanced ages can have a significant impact on an individual's quality of life and the ability to maintain personal independence. Relative to young adults, older adults make less impulsive and less risky choices; although these changes in decision making could be considered beneficial, they can also lead to choices with potentially negative consequences (e.g., avoidance of medical procedures). Rodent models of decision making have been invaluable for dissecting cognitive and neurobiological mechanisms that contribute to age-related changes in decision making, but they have predominantly used costs related to timing or probability of reward delivery and have not considered other equally important costs, such as the risk of adverse consequences. The current study therefore used a rat model of decision making involving risk of explicit punishment to examine age-related changes in this form of choice behavior in male rats, and to identify potential cognitive and neurobiological mechanisms that contribute to these changes. Relative to young rats, aged rats displayed greater risk aversion, which was not attributable to reduced motivation for food, changes in shock sensitivity, or impaired cognitive flexibility. Functional MRI analyses revealed that, overall, functional connectivity was greater in aged rats compared with young rats, particularly among brain regions implicated in risky decision making such as basolateral amygdala, orbitofrontal cortex, and ventral tegmental area. Collectively, these findings are consistent with greater risk aversion found in older humans, and reveal age-related changes in brain connectivity.

Social value at a distance: Higher identification with all of humanity is associated with reduced social discounting

How much we value the welfare of others has critical implications for the collective good. Yet, it is unclear what leads people to make more or less equal decisions about the welfare of those from whom they are socially distant. The current research sought to explore the psychological mechanisms that might underlie welfare judgements across social distance. Here, a social discounting paradigm was used to measure the tendency for the value of a reward to be discounted as the social distance of its recipient increased. Across two cohorts (one discovery, one replication), we found that a more expansive identity with all of humanity was associated with reduced social discounting. Additionally, we investigated the specificity of this association by examining whether this relationship extended to delay discounting, the tendency for the value of a reward to be discounted as the temporal distance to its receipt increases. Our findings suggest that the observed association with identity was unique to social discounting, thus underscoring a distinction in value-based decision-making processes across distances in time and across social networks. As data were collected during the COVID-19 pandemic, we also considered how stress associated with this global threat might influence welfare judgements across social distances. We found that, even after controlling for COVID-19 related stress, correlations between identity and social discounting held. Together, these findings elucidate the psychological processes that are associated with a more equal distribution of generosity.

The globalizability of temporal discounting

Economic inequality is associated with preferences for smaller, immediate gains over larger, delayed ones. Such temporal discounting may feed into rising global inequality, yet it is unclear whether it is a function of choice preferences or norms, or rather the absence of sufficient resources for immediate needs. It is also not clear whether these reflect true differences in choice patterns between income groups. We tested temporal discounting and five intertemporal choice anomalies using local currencies and value standards in 61 countries (N = 13,629). Across a diverse sample, we found consistent, robust rates of choice anomalies. Lower-income groups were not significantly different, but economic inequality and broader financial circumstances were clearly correlated with population choice patterns.

Reinforcer pathology of internet-related behaviors among college students: Data from six countries

Research has demonstrated that repeated engagement in low-effort behaviors that are associated with immediate reward, such as Internet use, can result in a pathological reinforcement process in which the behavior is increasingly selected over other activities due, in part, to a low availability of alternative activities and to a strong preference for immediate rather than delayed rewards (delay discounting). However, this reinforcer pathology model has not been generalized to other Internet-related behaviors, such as online gaming or smartphone use. Given the widespread availability of these technologies, it is also important to examine whether reinforcer pathology of Internet-related behaviors is culturally universal or culture-specific. The current study examines relations between behavioral economic constructs (Internet demand, delay discounting, and alternative reinforcement) and Internet-related addictive behaviors (harmful Internet use, smartphone use, online gaming, and Internet sexual behavior) in a cross-sectional sample of college students (N = 1,406) from six different countries (Argentina, Australia, India, Malaysia, the United Kingdom, and the United States). Using structural equation modeling, Internet demand was associated with harmful Internet use, smartphone use, and online gaming; delay discounting was associated with harmful smartphone use; and alternative reinforcement was associated with harmful Internet and smartphone use. The models were partially invariant across countries. However, mean levels of behavioral economic variables differed across countries, country-level gross domestic product, person-level income, and sex at birth. Results support behavioral economic theory and highlight the importance of considering both individual and country-level sociocultural contextual factors in models for understanding harmful engagement with Internet-related behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Time Horizons, Drug Use, and Risky Sex in Young Women from Poor Urban Areas

Aims

Emerging adulthood is marked by elevated risk-taking, and young people living in disadvantaged urban areas experience disproportionately more negative outcomes. Using a sample of young African American women living in such communities, this cross-sectional observational study investigated the hypothesis that greater substance use and sexual risk-taking would be associated with present-dominated time perspectives and higher delay discounting.

Methodology

Young women (N = 223, M age = 20.4 years) from disadvantaged urban areas were recruited using Respondent Driven Sampling, a peer-driven recruitment method. Structured field interviews assessed substance use, sexual practices, and risk/protective factors, including time perspectives (Zimbardo Time Perspective Inventory [ZTPI]) and behavioral impulsivity (delay discounting task).

Results

Regression models showed that present hedonism time perspectives were related to sexual risk-taking and substance involvement, whereas discounting was associated only with sexual risk-taking (ps < .05). Future time perspectives were not associated with either risk behavior.

Conclusions

Risk behaviors among young African American women living in disadvantaged urban areas appear to be related to hedonistic rewards available in the present without considering future outcomes. Future research should investigate experimentally if lengthening time perspectives and enriching views of possible futures may aid risk reduction in this population.

Unifying Evidence on Delay Discounting: Open Task, Analysis Tutorial, and Normative Data from an Italian Sample

Despite the widespread use of the delay discounting task in clinical and non-clinical contexts, several task versions are available in the literature, making it hard to compare results across studies. Moreover, normative data are not available to evaluate individual performances. The present study aims to propose a unified version of the delay discounting task based on monetary rewards and it provides normative values built on an Italian sample of 357 healthy participants. The most used parameters in the literature to assess the delay discount rate were compared to find the most valid index to discriminate between normative data and a clinical population who typically present impulsivity issues, i.e., patients with a lesion to the medial orbitofrontal cortex (mOFC). In line with our hypothesis, mOFC patients showed higher delay discounting scores than the normative sample and the normative group. Based on this evidence, we propose that the task and indexes here provided can be used to identify extremely high (above the 90th percentile for hyperbolic k or below the 10th percentile for AUC) or low (below the 10th percentile for hyperbolic k or above the 90th percentile for AUC) delay discounting performances. The complete dataset, the R code used to perform all analyses, a free and modifiable version of the delay discounting task, as well as the R code that can be used to extract all indexes from such tasks and compare subjective performances with the normative data here presented are available as online materials.

Deprivation Has Inconsistent Effects on Delay Discounting: A Review

Delay discounting, the tendency for outcomes to be devalued as they are more temporally remote, has implications as a target for behavioral interventions. Because of these implications, it is important to understand how different states individuals may face, such as deprivation, influence the degree of delay discounting. Both dual systems models and state-trait views of delay discounting assume that deprivation may result in steeper delay discounting. Despite early inconsistencies and mixed results, researchers have sometimes asserted that deprivation increases delay discounting, with few qualifications. The aim of this review was to determine what empirical effect, if any, deprivation has on delay discounting. We considered many kinds of deprivation, such as deprivation from sleep, drugs, and food in humans and non-human animals. For 23 studies, we analyzed the effect of deprivation on delay discounting by computing effect sizes for the difference between delay discounting in a control, or baseline, condition and delay discounting in a deprived state. We discuss these 23 studies and other relevant studies found in our search in a narrative review. Overall, we found mixed effects of deprivation on delay discounting. The effect may depend on what type of deprivation participants faced. Effect sizes for deprivation types ranged from small for sleep deprivation (Hedge's gs between −0.21 and 0.07) to large for opiate deprivation (Hedge's gs between 0.42 and 1.72). We discuss possible reasons why the effect of deprivation on delay discounting may depend on deprivation type, including the use of imagined manipulations and deprivation intensity. The inconsistency in results across studies, even when comparing within the same type of deprivation, indicates that more experiments are needed to reach a consensus on the effects of deprivation on delay discounting. A basic understanding of how states affect delay discounting may inform translational efforts.

Is irregular time estimation a common factor in smoking behavior and delay discounting?

INTRODUCTION

Smoking is known to be associated with steeper delay discounting which is a widely used measure of externalizing behavior. This study investigates individual aspects of time estimation and the extent to which these are associated with differences in delay discounting and smoking behavior.

METHODS

The study was conducted as an online experiment in a sample of undergraduate students (N = 495), including 51 smokers. Participants completed a serial time estimation, delay discounting task (MCQ), BIS/BAS questionnaire, Fagerstrom test for nicotine dependence and an alcohol use assessment (QFV).

RESULTS

Smoking, heavy drinking and delay discounting were associated with faster estimation of time. Furthermore, smoking and delay discounting were associated with differences in autocorrelation. Fun seeking was associated with smoking and alcohol use, but not with time estimation or delay discounting.

CONCLUSIONS

This study provides evidence for the hypothesis that an acceleration of the internal clock might lead to time over-estimation which could lead towards delayed consequence sensitivity and addiction. The study also found further evidence for the hypothesis that distortions in time estimation (i.e., autocorrelation) may be related to delay discounting and smoking. Smoking and delay discounting were associated with faster estimations of time and differences in autocorrelation.

Age-related effects in delay discounting for food

Developmental influences of growth, such as hormones and metabolic factors, increase food intake and weight across the lifespan. Delay discounting (DD), a choice procedure that characterizes preferences for immediate rewards, such as food, over larger, more delayed ones may be useful in understanding developmental and metabolic changes in decision making processes related to food intake. The present study examined the relation between age and food DD in a cross-sectional design. Other variables, such as pubertal stage, were examined also as these may influence discounting. Participants (N = 114; 28 children and 86 adult) from a community sample completed measures of food and money delay discounting to determine if age-related variation in discounting tendencies is food-specific or more general. Both measures yield an omnibus discounting value and three additional values for small, medium, and large magnitudes. Analyses first revealed magnitude effects-- smaller magnitudes of both food and money were discounted more steeply than larger magnitudes. Hierarchical regressions indicated subjective hunger predicted steeper food discounting. When subjective hunger was controlled, age, but not puberty, significantly predicted food discounting for omnibus, medium, and large magnitudes of food. In children, food discounting decreased from early childhood to late adolescence. In adults, food discounting increased from early to late adulthood. Neither age, puberty, nor obesity status predicted any measure of monetary discounting. Food discounting, then, appears to change across the lifespan, and therefore, may be appropriate to examine psychological processes that accompany developmental and metabolic changes across the lifespan.

Microfoundations of Discounting

An important question in economics is how people choose between different payments in the future. The classical normative model predicts that a decision maker discounts a later payment relative to an earlier one by an exponential function of the time between them. Descriptive models use nonexponential functions to fit observed behavioral phenomena, such as preference reversal. Here we propose a model of discounting, consistent with standard axioms of choice, in which decision makers maximize the growth rate of their wealth. Four specifications of the model produce four forms of discounting—no discounting, exponential discounting, hyperbolic discounting, and a hybrid of exponential and hyperbolic discounting—two of which predict preference reversal. Our model requires no assumption of behavioral bias or payment risk.

The Role of Impulsive Decision Making on Health Behavior Related to Cardiovascular Disease Risk Among Older Adults With Hypertension

The purpose of the current study was to investigate whether older adults who are more impulsive also tend to engage in more health behaviors associated with increased risk for cardiovascular disease (CVD). We analyzed data from the Health and Retirement Study. Logistic regression analysis was performed to determine the likelihood of medication adherence, alcohol consumption, and exercise among older adults with hypertension. Adjusted regression results revealed higher impulsive decision making was associated with greater likelihood of obesity (odds ratio [OR] = 2.96, 95% confidence interval [CI] [1.00, 8.92]), lower likelihood of medication adherence (OR = 0.37, 95% CI [0.15, 0.92]), and regular drinking (OR = 0.36, 95% CI [0.15, 0.87]). Higher impulsive decision making was associated with lower likelihood of regular exercise only in unadjusted models. Older adults with hypertension who had higher impulsive decision making engaged in health behaviors associated with increased risk for CVD. Health care providers should consider the range of strategies offered through behavioral economics to improve health in these at-risk populations. [Journal of Gerontological Nursing, 47(11), 22-30.].

The Effect of Delay Duration on Delay Discounting across Adulthood

Objectives

Literature about the relationship between age and delay discounting, or the willingness to wait for delayed rewards, is mixed. We posit that some of this heterogeneity may be attributable to inconsistent delay durations across studies. Here we investigate how delay duration influences discounting across adulthood by systematically varying the duration of the delay between the smaller, sooner and the larger, later option.

Methods

288 healthy participants (age range: 25–84 years) completed an online delay discounting task that probed 12 different time delays across 3 discount rates. Discounting was analyzed in 2 statistical models that treated delay duration as either a categorical or a continuous predictor.

Results

Longer delays were generally associated with decreased discounting. However, this was dependent on both age of the participant and delay duration. Both models revealed that, at short to moderate time delays, older adults discounted less than younger adults. However, at very long delays (5 and 10 years), older adults discounted at similar rates to younger adults.

Discussion

Results suggest that delay length can moderate the relationship between age and discounting. Using delays longer than those tested here (>10 years) could reveal yet another trend (i.e., a reversal) to those found here. Future research should investigate whether this reversal in discounting exists, why it exists, and where the inflection point lies.

Endorsement of specific alcohol use disorder criterion items changes with age in individuals with persistent alcohol use disorders in 2 generations of the San Diego Prospective Study

BACKGROUND

Diagnostic and Statistical Manual (DSM) alcohol use disorder (AUD) criteria are written in broad enough terms to apply to diverse populations. The current analyses evaluate whether the endorsement of criteria changes with increasing age in individuals with persistent AUDs.

METHODS

Data regarding AUDs persisting across 3 timepoints between average ages of 31 and 43 were gathered about every 5 years from 318 interviews for 106 San Diego Prospective Study (SDPS) AUD male probands. Similar data regarding persistent AUDs across 2 timepoints were obtained from 136 interviews with 68 SDPS AUD offspring between average ages of 21 and 27. Changes in the endorsement of each AUD criterion were evaluated using Cochran's Q test.

RESULTS

For AUD probands across time, significant decreases were observed in the proportions endorsing 4 criteria (tolerance, withdrawal, failure to fulfill obligations, and using alcohol in hazardous situations). Increased rates of endorsement were documented for 3 criteria (drinking alcohol in higher amounts or for longer periods of time, spending a great deal of time regarding alcohol, and continued use despite social or interpersonal problems). Significant increases in rates of endorsements for offspring were seen for spending a great deal of time regarding alcohol and giving up or reducing important activities in order to drink.

CONCLUSIONS

These data indicate that the salience of many DSM AUD criterion items changed significantly with age in both SDPS generations among individuals with persistent AUDs. The current results support the need for additional systematic research to determine whether specific criterion items might need to be weighted differently in evaluating older and younger individuals with persistent AUDs.

The effect of testosterone on economic risk-taking: A multi-study, multi-method investigation

Testosterone has been suggested to influence individuals' economic decision making, yet the effects of testosterone on economic behavior are not well-understood and existing research is equivocal. In response, in three studies, we examined the extent to which testosterone affected or was associated with several different facets of economic decision making. Study 1 was a double-blind, placebo-controlled, within-subjects study examining loss aversion and risk-taking (N = 26), whereas Study 2 was a larger double-blind, placebo-controlled, between-subjects study examining loss aversion and risk-taking behavior (N = 117). As a methodological compliment, Study 3 was a larger correlational design (N = 213) with a highly accurate measure of endogenous testosterone examining a wider range of economic behaviors and trait-like preferences. Broadly, the results of all three studies suggest no consistent relationship between testosterone and financial behavior or preferences. Although there were significant effects in specific cases, these findings did not replicate in other studies or would not remain significant when controlling for family-wise error rate. We consider potential contextual moderators that may determine under what circumstances testosterone affects economic decision making.

Delay discounting, cognitive ability, and personality: What matters?

Steep delay discounting is associated with problems such as addiction, obesity, and risky sexual behavior that are frequently described as reflecting impulsiveness and lack of self-control, but it may simply indicate poor cognitive functioning. The present investigation took advantage of the unique opportunity provided by the Human Connectome Project (N=1,206) to examine the relation between delay discounting and 11 cognitive tasks as well as the Big Five fundamental personality traits. With income level and education statistically controlled, discounting was correlated with only four of the 11 cognitive abilities evaluated, although the rs were all small (<.20). Importantly, the two discounting measures loaded on their own factor. Discounting was not correlated with Neuroticism or Conscientiousness, traits related to psychometric impulsiveness and self-control. These findings suggest that steep delay discounting is not simply an indicator of poor cognitive functioning or psychometric impulsiveness but an important individual difference characteristic in its own right.

Applying Behavioral Economics to Improve Adolescent and Young Adult Health: A Developmentally-Sensitive Approach

Each day, adolescents and young adults (AYAs) choose to engage in behaviors that impact their current and future health. Behavioral economics represents an innovative lens through which to explore decision-making among AYAs. Behavioral economics outlines a diverse set of phenomena that influence decision-making and can be leveraged to develop interventions that may support behavior change. Up to this point, behavioral economic interventions have predominantly been studied in adults. This article provides an integrative review of how behavioral economic phenomena can be leveraged to motivate health-related behavior change among AYAs. We contextualize these phenomena in the physical and social environments unique to AYAs and the neurodevelopmental changes they undergo, highlighting opportunities to intervene in AYA-specific contexts. Our review of the literature suggests behavioral economic phenomena leveraging social choice are particularly promising for AYA health. Behavioral economic interventions that take advantage of AYA learning and development have the potential to positively impact youth health and well-being over the lifespan.

Temporal discounting mediates the relationship between socio-economic status and social trust

Social trust and income are associated both within and across countries, such that higher income typically correlates with increased trust. While this correlation is well-documented, the psychological mechanisms sustaining this relationship remain poorly understood. One plausible candidate is people's temporal discounting: on the one hand, trust has a strong time component-it exposes the individual to immediate costs in exchange of uncertain and delayed benefits; on the other hand, temporal discounting is robustly influenced by income. The goal of our studies was to test whether temporal discounting mediates the relationship between income and trust and whether experimentally manipulating perceived income has a downstream impact on temporal discounting and trust. To do so, participants who underestimated their relative income position received information about their true position in the income distribution in order to correct their misperception. Our results indicate that temporal discounting partially mediates the effect of income on social trust in a pre-registered online study on British participants (N = 855). However, receiving a positive information shock on one's income position had no impact on either temporal discounting or social trust. In a second pre-registered study, we replicated the finding that temporal discounting partially mediates the effect of income on social trust in a representative sample of the British population (N = 1130).

Delay discounting and obesity in food insecure and food secure women

OBJECTIVES

The relation between food insecurity (FI) and delay discounting (DD) and probability discounting (PD) for food and money was tested in women. In addition, discounting was tested as a variable that mediates the relation between obesity and FI.

METHOD

Women recruited from a community sample (N = 92) completed questionnaires. They completed the food choice questionnaire, the monetary choice questionnaire, measures for food and money probability discounting (which quantify sensitivity to risk aversion), and demographic measures.

RESULTS

Women with FI had higher rates of obesity and higher food DD compared to food-secure women. However, DD for money or probability discounting for food or money did not significantly differ between FI and food secure groups when controlling for significant covariates. Neither DD or PD significantly mediated the relation between FI and obesity.

CONCLUSIONS

These results suggest that FI is associated with greater impulsive food choice, but its association with other monetary discounting and probability discounting for food and money appears contingent upon other demographic factors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Factors Influencing College Football Players' Beliefs About Incurring Football-Related Dementia

Background:

Football participation is associated with risks to acute and long-term health, including the possibility of incurring football-related dementia. Concerns have been raised regarding media coverage of these risks, which may have influenced athletes’ beliefs. However, little is known about football players’ views on football-related dementia. The risk-perception literature suggests that related risk perceptions and features of individual cognition, such as the ability to switch to reasoned, deliberative thinking, may influence individual perception of a long-term risk.

Purpose:

To evaluate factors influencing college football players’ belief that they are likely to incur football-related dementia in the future.

Study Design:

Cross-sectional study.

Methods:

Members of 4 National Collegiate Athletic Association Division I Power 5 Football teams participated in this survey-based study, providing responses to demographic, athletic, and risk-posture questions, and completed the cognitive reflection test. Logistic regressions were used to evaluate relationships between beliefs about football-related dementia and factors including athletic and demographic characteristics, football risk posture, health-risk posture, and cognitive reflection test score.

Results:

About 10% of the 296 participating athletes thought football-related dementia was likely to occur in their future. Skill players had lower odds than linemen of believing that football-related dementia was likely (odds ratio [OR], 0.35; 95% CI, 0.14-0.89). For each additional suspected concussion in an athlete’s career, his odds of believing football-related dementia was likely increased by 24% (OR, 1.24; 95% CI, 1.07-1.45). Acute and chronic football-related risk perceptions, as well as non–football-related health-risk perceptions, were positively associated with athletes’ belief that football-related dementia was likely. Higher cognitive reflection test scores, a measure of ability to switch to slow, deliberative thinking, was positively associated with odds of believing football-related dementia was likely (OR, 1.57; 95% CI, 1.12-2.21).

Conclusion:

Some athletes view football as generally riskier, while others view football as generally lessri sky. These risk postures are informed by athletes’ concussion history, primary playing position, and ability to switch from fast, reactive thinking to slow, deliberative thinking. Ensuring that athletes are appropriately informed of the risks of participation is an ethical obligation of universities; sports medicine clinicians are appropriate facilitators of conversations about athletes’ health risks.

Impulsivity and self-control in elementary school children and adult females: Using identical task and procedural parameters

Results of studies examining the relationship between impulsivity and age are limited because different tasks, procedural parameters, and different reinforcers have been used with different aged participants. Thus, the current study sought to rectify these differences in two experiments with children (42, ages 5-12) and adults (69 college-aged females) using the same task with identical procedural parameters. In the Self-Control Video Software Task (SCVST; Forzano and Schunk, 2008; Forzano et al., 2014) participants repeatedly choose between larger, more delayed and smaller, less delayed access to viewing video cartoons. No differences in impulsivity were found between adults and children. No age or gender differences were found among children. Differences in task and procedural parameters are identified as important in their implications for research on impulsivity.

The neurodevelopment of delay discounting for monetary rewards in pre-adolescent children

Children are found to exhibit high degrees of delay discounting compared with adults in many delay discounting studies, which might be due to the asynchronous development of "bottom-up" and "top-down" neural systems. However, the temporal dynamics associated with the two systems in the development of delay discounting processes are not well known. In this study, we chose two age groups of participants and adopted event-related potential (ERP) techniques to investigate the neural dynamic differences between children and adults during delay discounting processes. Behavioral findings showed that children discounted more than adults and chose more immediate choices. Electrophysiological findings revealed that children exhibited longer neural processing (longer P2 latency) than adults during the early detection and identification phase. Children showed less cognitive control (smaller N2 amplitude) than adults over the middle frontal areas, and they devoted more neural effort (larger P3 amplitudes) to making final choices than adults. The factors of reward amount and time delay could influence the development of delay discounting in children.

Reconsidering delay discounting in bulimia nervosa

Delay discounting measures one's preference for smaller-sooner versus larger-later reward and is a facet of impulsivity. Studying delay discounting in bulimia nervosa (BN) may enhance clinical understanding of BN, as BN is characterized by engagement in behaviors that provide immediate reward (i.e., binge eating, purging) at the expense of future well-being. Prior research suggests that individuals with BN prefer smaller amounts of money available sooner compared to psychiatrically healthy (HC) persons. Here, we aimed to replicate and extend previous work by studying delay discounting of both monetary and food reward in women with BN relative to HC women. We also compared delay discounting of monetary and food reward, and examined associations among delay discounting, trait impulsivity, and eating disorder symptom expression in women with BN. Participants were 20 women with sub- or full-threshold DSM-5 BN and 20 HC women who completed a diagnostic interview, paper-and-pencil measures of delay discounting of monetary and food commodities, and a measure of trait impulsivity. Contrary to previous work, we found that women with BN showed decreased delay discounting of monetary and food reward relative to HC women. Within-group analyses demonstrated that women with BN showed elevated delay discounting of food reward relative to monetary reward. Within women with BN, elevated delay discounting of food, but not money, was associated with elevated negative and positive urgency, two facets of trait impulsivity that relate to acting rashly when experiencing strong emotion. Results suggest that delay discounting may be more variable in BN than previously assumed.

Behavioral economic indicators of risky drinking among community-dwelling emerging adults

Objective: Behavioral economic (BE) approaches to understanding and reducing risky drinking among college students are well established, but little is known about the generalizability of prior findings to peers who currently are not traditional college students and are more difficult to reach for assessment and intervention. This cross-sectional survey investigated whether drinking practices and negative consequences were associated with greater alcohol demand, alcohol reward value, and delay discounting in this target population. Method: Community-dwelling emerging adult drinkers aged 21 to 29 (N = 357) were recruited using Respondent-Driven Sampling adapted to a digital platform (Mage = 23.6 years, 64% women). Peers recruited peers in an iterative fashion. Participants completed a web-based survey of drinking practices, negative alcohol-related consequences, and BE measures of alcohol demand, alcohol reward value, and delay discounting. Results: Regression analyses supported the study hypotheses. Higher alcohol demand (intensity and elasticity) predicted higher drinks per drinking day, more past-month drinking days, and more negative consequences. Higher alcohol reward value (discretionary alcohol spending and alcohol-involved activities) and stronger preference for sooner smaller versus later larger rewards predicted select drinking risk variables in the hypothesized direction (p < .05). Conclusions: BE risk characteristics were generalized to community-dwelling emerging adult risky drinkers, with the most consistent associations found between alcohol demand and drinking risk measures. The findings lay a foundation for extending successful BE interventions with college drinkers to this underserved population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Delay discounting rate by a surrogate decision maker depends on the smoking status of the recipient

The tendency to devalue future rewards is known as delay discounting. Discounting is measured using a series of intertemporal choices between smaller, sooner outcomes and larger, later outcomes. We used a surrogate delay discounting task to explore whether such choices would differ if a hypothetical recipient was a smoker or was an individual with good health habits. Across three studies, the descriptions of the recipient included only information about smoking status (n = 66), smoking status and equal annual income (n = 47), and smoking status and equal weekly expenditures (n = 42). Higher rates of delay discounting for the smoker recipient compared to the nonsmoker recipient were observed across all three studies. These results parallel previous findings showing group differences in discounting between actual smokers and nonsmokers. We discuss the similarities between the present results and previous studies in light of an extension of Bem's (1967) self-perception theory, which posits that choices in laboratory-based delay discounting tasks are informed by observation of real-world intertemporal choice. The theory asserts that there is no fundamental difference between a first-person account of such knowledge and a third-person account. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Improvement of Working Memory is a Mechanism for Reductions in Delay Discounting Among Mid-Age Individuals in an Urban Medically Underserved Area

BACKGROUND

Delay discounting, or the tendency to devalue rewards as a function of their delayed receipt, is associated with myriad negative health behaviors. Individuals from medically underserved areas are disproportionately at risk for chronic health problems. The higher rates of delay discounting and consequent adverse outcomes evidenced among low-resource and unstable environments suggest this may be an important pathway to explain health disparities among this population.

PURPOSE

The current study examined the effectiveness of a computerized working memory training program to decrease rates of delay discounting among residents of a traditionally underserved region.

METHODS

Participants (N = 123) were recruited from a community center serving low income and homeless individuals. Subjects completed measures of delay discounting and working memory and then took part in either an active or control working memory training.

RESULTS

Analyses indicated that participants in the active condition demonstrated significant improvement in working memory and that this improvement mediated the relation between treatment condition and reductions in delay discounting.

CONCLUSIONS

Results suggest that a computerized intervention targeting working memory may be effective in decreasing rates of delay discounting in adults from medically underserved areas (ClinicalTrials.gov number NCT03501706).

Cognitive Dynamics of Religiosity and Intertemporal Choice Behavior

The preference for smaller-sooner rewards over larger-delayed ones (temporal discounting, TD) has been suggested to be influenced by religiosity, through its role in enhancing self-control. Here we investigate this issue in Muslims, Catholics, and two control groups of Italian and Iranian atheists, by measuring implicit religiosity (implicit association test, IAT) and the cognitive dynamics underlying TD (using mouse tracking). Results showed that Muslims are the most farsighted, while Catholics are the most shortsighted and both atheists’ groups fall in between these two extremes; additionally, these results are also shaped by implicit religiosity (IAT). Mouse tracking analyses reveal that Muslims show higher cognitive conflict compared to the other groups, which arises only in later stages of processing. This indicates that farsighted behavior in Muslims requires the recruitment of self-control in order to regulate intertemporal decision-making. Our findings suggest that the highly demanding religious precepts enforced in (most) Islamic communities may help strengthen self-control abilities.

Age-Related Differences in Motivational Integration and Cognitive Control

Motivational incentives play an influential role in value-based decision-making and cognitive control. A compelling hypothesis in the literature suggests that the motivational value of diverse incentives are integrated in the brain into a common currency value signal that influences decision-making and behavior. To investigate whether motivational integration processes change during healthy aging, we tested older (N = 44) and younger (N = 54) adults in an innovative incentive integration task paradigm that establishes dissociable and additive effects of liquid (e.g., juice, neutral, saltwater) and monetary incentives on cognitive task performance. The results reveal that motivational incentives improve cognitive task performance in both older and younger adults, providing novel evidence demonstrating that age-related cognitive control deficits can be ameliorated with sufficient incentive motivation. Additional analyses revealed clear age-related differences in motivational integration. Younger adult task performance was modulated by both monetary and liquid incentives, whereas monetary reward effects were more gradual in older adults and more strongly impacted by trial-by-trial performance feedback. A surprising discovery was that older adults shifted attention from liquid valence toward monetary reward throughout task performance, but younger adults shifted attention from monetary reward toward integrating both monetary reward and liquid valence by the end of the task, suggesting differential strategic utilization of incentives. These data suggest that older adults may have impairments in incentive integration and employ different motivational strategies to improve cognitive task performance. The findings suggest potential candidate neural mechanisms that may serve as the locus of age-related change, providing targets for future cognitive neuroscience investigations.

Is it time? Episodic imagining and the discounting of delayed and probabilistic rewards in young and older adults

Remembering and imagining specific, personal experiences can help shape our decisions. For example, cues to imagine future events can reduce delay discounting (i.e., increase the subjective value of future rewards). It is not known, however, whether such cues can also modulate other forms of reward discounting, such as probability discounting (i.e., the decrease in the subjective value of a possible reward as the odds against its occurrence increase). In addition, it is unclear whether there are age-related differences in the effects of cueing on either delay or probability discounting. Accordingly, young and older adult participants were administered delay and probability discounting tasks both with and without cues to imagine specific, personally meaningful events. As expected, cued episodic imagining decreased the discounting of delayed rewards. Notably, however, this effect was significantly less pronounced in older adults. In contrast to the effects of cueing on delay discounting, personally relevant event cues had little or no effect on the discounting of probabilistic rewards in either young or older adults; Bayesian analysis revealed compelling support for the null hypothesis that event cues do not modulate the subjective value of probabilistic rewards. In sum, imagining future events appears only to affect decisions involving delayed rewards. Although the cueing effect is smaller in older adults, nevertheless, it likely contributes to how adults of all ages evaluate delayed rewards and thus, it is, in fact, about time.

Tobacco Dependence Treatment in Oncology: Initial Patient Clinical Characteristics and Outcomes from Roswell Park Comprehensive Cancer Center

Despite the importance of smoking cessation to cancer care treatment, historically, few cancer centers have provided treatment for tobacco dependence. To address this gap, the National Cancer Institute (NCI) launched the Cancer Center Cessation Initiative (C3i). As part of this effort, this study examined implementation outcomes in a cohort of cancer survivors (CSs) who smoked cigarettes in the first year of an ongoing process to develop and implement a robust Tobacco Treatment Service at Roswell Park Comprehensive Cancer Center. We provide a comprehensive description of the new tobacco use assessment and referral process, and of the characteristics of cancer survivors who agreed to treatment including traditional tobacco-related psychosocial and cancer treatment-related characteristics and novel characteristics such as delay discounting rates. We also examine characteristic differences among those who agreed to treatment between those who attended and those who did not attend treatment. As the new tobacco assessment was implemented, the number of referrals increased dramatically. The mean number of treatment sessions attended was 4.45 (SD = 2.98) and the six-month point prevalence intention to treat abstinence rate among those who attended was 22.7%. However, only 6.4% agreed to treatment and 4% attended at least one treatment session. A large proportion of cancer survivors who agreed to treatment were women, of older age, of lower socioeconomic status (SES), and who had high levels of depressive symptomology. The findings demonstrate that the implementation of system changes can significantly improve the identification of cancer survivors who use tobacco and are referred to tobacco use treatment. Among those who attend, treatment is effective. However, the findings also suggest that a systematic assessment of barriers to engagement is needed and that cancer survivors may benefit from additional treatment tailoring. We present plans to address these implementation challenges. Systematic electronic medical record (EMR)-sourced referral to tobacco treatment is a powerful tool for reaching cancer survivors who smoke, but more research is needed to determine how to enhance engagement and tailor treatment processes.

Delay discounting and risky choice: Meta-analytic evidence regarding single-process theories

Preferences about delayed rewards and preferences about risk are central to the literature on decision making. Several proposals suggest that such preferences arise from a single process and thus predict strong associations between preferences about delay and risk. Although there is a wealth of data on this association, the evidence is inconclusive; some studies have reported significant associations but many have not. Consequently, it is unclear whether the association between delay preferences and risk preferences is strong enough to support single-process theories. To further explore this question, we took a meta-analytic approach surveying 26 studies totaling 32 effect sizes. Results reveal a small to moderate association between risk preferences and delay preferences. This result provides little support for existing proposals because the observed relationship is no stronger than associations observed between either delay preferences or risk preferences and other variables. Moderating variables provide some explanation for inconsistencies across studies. Implications, including the apparent discrepancy between this literature and the conventional construct of impulsivity, are also discussed.

Food is discounted more steeply than money: Evidence from N2 and P3 responses in delay discounting tasks

In decision making, different rewards such as money and food may lead to different behavioral outcomes and neural dynamics. In this study, we used event-related potential (ERP) techniques and delay discounting tasks with money and snacks as rewards to determine whether there are differences in behavior and neurophysiology across the two tasks. The results showed that participants not only behaved differently but also showed different neural patterns in the money and snack tasks. In particular, at the behavioral level, participants discounted snacks more than money. At the neural level, the N2 amplitudes in the snack task were more negative than those in the money task. It was also discovered that for females, the amplitudes of P3 in the snack task were larger than those in money, while there was no difference for males. The current study showed the essential roles of frontal cognitive control function during varied delay discounting processes on money and food rewards.

Links between autobiographical memory richness and temporal discounting in older adults

When making choices between smaller, sooner rewards and larger, later ones, people tend to discount future outcomes. Individual differences in temporal discounting in older adults have been associated with episodic memory abilities and entorhinal cortical thickness. The cause of this association between better memory and more future-oriented choice remains unclear, however. One possibility is that people with perceptually richer recollections are more patient because they also imagine the future more vividly. Alternatively, perhaps people whose memories focus more on the meaning of events (i.e., are more "gist-based") show reduced temporal discounting, since imagining the future depends on interactions between semantic and episodic memory. We examined which categories of episodic details - perception-based or gist-based - are associated with temporal discounting in older adults. Older adults whose autobiographical memories were richer in perception-based details showed reduced temporal discounting. Furthermore, in an exploratory neuroanatomical analysis, both discount rates and perception-based details correlated with entorhinal cortical thickness. Retrieving autobiographical memories before choice did not affect temporal discounting, however, suggesting that activating episodic memory circuitry at the time of choice is insufficient to alter discounting in older adults. These findings elucidate the role of episodic memory in decision making, which will inform interventions to nudge intertemporal choices.

Changes in delay discounting, substance use, and weight status across adolescence

OBJECTIVE

Higher rates of delay discounting have been consistently linked to maladaptive health behaviors, including substance use and overeating, among adults. Despite adolescence representing a critical period for the escalation of these risky health behaviors, little is known about the developmental course of delay discounting or how this construct relates to important health outcomes in youth. The current study examined change in delay discounting over time using a latent growth curve approach and the relation between growth in this construct and changes in substance use and body-mass index over a 6-year period.

METHOD

Participants included 247 adolescents (44% female) with a mean age of 13 at the initial assessment.

RESULTS

Findings suggest that, on average, rates of delay discounting are stable across adolescence; however, there are significant individual differences around this trajectory. Moreover, youth who demonstrate significant increases in delay discounting over time are also more likely to experience more rapid escalations of both substance use and Body Mass Index across adolescence.

CONCLUSIONS

Results indicate that delay discounting is an important trans-disease process among adolescents. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Age Differences in Intertemporal Choice: The Role of Task Type, Outcome Characteristics, and Covariates

OBJECTIVES

Prior research has revealed age differences in the preferred timing of monetary outcomes, but results are inconsistent across studies. The present study examined the role of task type, outcome characteristics, and a range of theoretically implicated covariates that may contribute to variations in age effects.

METHOD

Two types of intertemporal choice paradigms (temporal discounting and sequence construction) were administered to a diverse life-span sample (n = 287, aged 18-87). The design experimentally manipulated outcome delay (months vs years), amount (hundreds vs thousands), and valence (gain vs loss) while statistically controlling for a range of potential covariates including demographics, affect, personality, time perspective, subjective health, and numeracy.

RESULTS

In the temporal discounting task, no significant age differences were observed and this pattern did not differ by outcome delay, amount, or valence. In the sequence-construction task, age was associated with a preference for sequences of decreasing impact in the gain condition but not in the loss condition, whereas outcome delay and amount did not moderate age effects. Age patterns in discounting and sequences preferences remained unchanged after controlling for covariates.

DISCUSSION

These findings converge with prior studies reporting weak or null effects of age in temporal discounting tasks and suggest that inconsistent results are not due to variations in outcome valence, delay, or amount across studies. Findings also add to the scarce evidence for age differences sequence-preferences. After discussing methodological limitations, we consider implications for future research and practice.

The effect of executive function on adherence with a cardiac secondary prevention program and its interaction with an incentive-based intervention

Participation in secondary prevention programs such as cardiac rehabilitation (CR) reduces morbidity, mortality, and hospitalizations while improving quality of life. Executive function (EF) is a complex set of cognitive abilities that control and regulate behavior. EF predicts many health-related behaviors, but how EF interacts with interventions to improve treatment adherence is not well understood. The objective of this study is to examine if EF predicts CR treatment adherence and how EF interacts with an intervention to improve adherence. Data were collected from 2013 to 2018 in Vermont, USA. 130 Medicaid-enrolled individuals who had experienced a qualifying cardiac event were enrolled in a controlled clinical trial and randomized 1:1 to receive financial incentives for completing secondary prevention sessions or to usual care. In this secondary analysis, effects of EF on CR adherence (defined as completing ≥30/36 sessions) were examined in 112 participants (57 usual care, 55 intervention) who completed an EF battery. Delay-discounting, a measure of impulsivity, predicted CR adherence (p = 0.01) and interacted with the incentive intervention, such that those who exhibited greater discounting of future rewards benefitted more from the intervention than those who discounted less (F(1, 104) = 5.23, p = 0.02). Better cognitive flexibility, measured with the trail-making-task, also predicted CR adherence (p = 0.02). While EF has been associated with adherence to a variety of treatment regimens, this interaction between an incentive-based intervention to promote treatment adherence and EF is novel. This work illustrates the value of considering individual differences in EF when designing and implementing interventions to promote health-related behavior change.